Summary

We worked closely with the community, staff, residents, and families of those living in the aged care facility on Norfolk Island to address their most pressing issue; the activity levels of the residents.

View a poster from the Centre for Healthcare Redesign graduation, December 2018.

Aim

By July 2019 all 14 permanent residents within the residential aged care facility on Norfolk Island will receive individual ability/interest assessments and recreation and leisure care plans. This will increase activity levels of at least 75% of the residents by 50% from baseline by 31 August 2019.

Benefits

Residents

Improved physical and mental health

Improved experience of care

Improved quality of life

Decreased use of medication

Decreased challenging behaviours

Staff

Improved staff morale

System

Decreased cost of care

Background

In July 2016 the Commonwealth took responsibility of Norfolk Island, a previously self-governing external territory. South Eastern Sydney Local Health District was tasked with assisting the local health service, Norfolk Island Health and Aged Care Service (NIHRACS), to support and enhance service delivery in line with other jurisdictions on the mainland.

NIHRACS is a multipurpose service, housing acute care facilities, aged care facilities, and the island’s only general practice. Staff work across different departments, depending on the identified needs.Interviews, monitoring and direct observation indicated that residents living in NIHRACS experienced low levels of activity. There were limited individualised assessments, no goals around activity levels, and no processes supporting enrichment activities. The diversional therapist role was new and had not received mentorship or training. The residents, staff, and community were not happy with the breadth and amount of activities being offered to the residents, as well as the uptake of such activities.

Implementation

Training and mentorship for the diversional therapistThe diversional therapist was offered training in the form of a Cert IV in Leisure and Health. This has been delayed due to staffing issues. Mentorship via telehealth was organised with a senior diversional therapist in the LHD, and final sign off on this is expected by the end of November 2018.

PolicyA policy was developed outlining the expectations and values of the multipurpose service with regards to resident activity, as well as processes for back-filling. This was completed by November 2018.

Assessment A process and related resources were developed to facilitate the assessment of all residents in the facility in terms of ability and interests around activities. This was completed in November 2018, with assessments underway.

Planning A process and related resources are being developed to plan and track activity levels, based on the assessments.

Equipment The purchase of appropriate equipment was facilitated by creating networks and formal linkages with a large, well resourced,, aged care facility on the mainland who are able to provide advice on up-to-date best practice. Equipment has been purchased, and this relationship is ongoing.

Status

Implementation – The project is ready for implementation or is currently being implemented, piloted or tested.